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Management of Diabetic Ketoacidosis

  • Symposium on PICU Protocols of AIIMS
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Abstract

Diabetic ketoacidosis (DKA), a life-threatening complication of diabetes mellitus (DM), occurs more commonly in children with type 1 DM than type 2 DM. Hyperglycemia, metabolic acidosis, ketonemia, dehydration and various electrolyte abnormalities result from a relative or absolute deficiency of insulin with or without an excess of counter-regulatory hormones. Management requires careful replacement of fluid and electrolyte deficits, intravenous administration of insulin, and close monitoring of clinical and biochemical parameters directed towards timely detection of complications, including hypokalemia, hypoglycemia and cerebral edema. Cerebral edema may be life threatening and is managed with fluid restriction, administration of mannitol and ventilatory support as required. Factors precipitating the episode of DKA should be identified and rectified. Following resolution of ketoacidosis, intravenous insulin is transitioned to subcutaneous route, titrating dose to achieve normoglycemia.

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Authors and Affiliations

  1. Department of Pediatrics, All India institute of Medical Sciences, Ansari Nagar, New Delhi, India

    Sindhu Sivanandan, Aditi Sinha, Vandana Jain & Rakesh Lodha

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  1. Sindhu Sivanandan
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  2. Aditi Sinha
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  4. Rakesh Lodha
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Correspondence to Rakesh Lodha.

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Sivanandan, S., Sinha, A., Jain, V. et al. Management of Diabetic Ketoacidosis. Indian J Pediatr 78, 576–584 (2011). https://doi.org/10.1007/s12098-010-0294-8

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  • DOI: https://doi.org/10.1007/s12098-010-0294-8

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